New Resuscitation Approach for Heart Attacks Looks Promising
Researchers associated with the Mayo Clinic in Scottsdale, Arizona, have disclosed promising results from a new method of treating heart attack patients when their cardiac arrest occurs outside a hospital setting. In 2004, the survival rate for such cardiac events was only 3% in the state. Survival is recognized as the ability of the cardiac patient to live long enough to be discharged from the hospital.
The new treatment, called minimally interrupted cardiac resuscitation (MICR), involves a process of coordinated steps that must be administered by emergency medical services personnel (EMS). The steps for the new procedure are as follows:
- 200 uninterrupted chest compressions.
- Single shock rhythm analysis
- 200 additional uninterrupted chest compressions immediately following shock.
- Rhythm re-analysis or pulse check.
- Early dose of epinephrine, a heart stimulant.
- Delayed insertion of an endotracheal tube, used to bring air to the lungs.
The new procedure was tested in two Arizona metropolitan areas and 60 fire departments.
In an assessment of all out-of-hospital cardiac arrests in the study zones, patients who received MICR treatment enjoyed a 9.1% survival rate, up from the 3.8% survival rate of those who did not receive it.
In some of the cardiac arrests, patients had a witnessed cardiac arrest, meaning they had an irregular, chaotic heartbeat that could be detected by EMS personnel. In this type of case, a patient is more likely to benefit from defibrillation than a patient with no detectable, or witnessed, heart beat. This group of cardiac arrest patient fares better, in general, for both types of resuscitation procedures but those who received MICR had a higher survival rate (28.4%) than those who received traditional treatment (11.9%).
Researchers cite the uninterrupted compressions as the key to survival in MICR treatment. The continued flow of blood, especially to the brain, minimizes the risk of severe neurological damage and increases the likelihood of returning home after hospital treatment.
The March 12 issue of JAMA carries full details of the study and the treatment procedures.
